Tooth extraction is a fairly straightforward and standard dental procedure but it can be nerve-wracking for many people. You could need a tooth extraction for many reasons. Dentists and oral surgeons commonly recommend removing a decayed or damaged tooth or pulling a painful wisdom tooth. Sometimes, dentists extract a tooth to make space in an overcrowded mouth in someone who is undergoing orthodontic treatment with braces.
Knowing what to expect can help alleviate some of the anxiety associated with a tooth extraction. What does the tooth extraction procedure involve? How do you prepare for it? What kind of aftercare is needed? And how much does tooth extraction cost? Keep reading to learn everything there is to know about tooth extractions.
What is tooth extraction? Why is it performed?
Simply put, tooth extraction is the removal of a tooth from the mouth with tools in a dentist’s office. It can be recommended for various reasons, the most common of which are listed below:
- Decayed tooth due to dental cavities
- Gum disease
- Dental infection
- Trauma or injury to a tooth or jawbone
- Overcrowding (not enough room in your mouth for all your teeth)
- Orthodontic treatment (to create space for teeth as they move in the mouth)
- Delayed falling out of milk teeth, preventing the permanent teeth from coming in
- Wisdom tooth extraction (removal of the third molar)
One of the common reasons for tooth extraction is tooth decay and dental caries. Caries or cavities are holes in the tooth caused by plaque (plaque is a sticky substance consisting of bacteria, food, saliva, and acid).
The reason why dentists keep reminding you to brush your teeth twice a day and floss once a day is that it is essential to remove plaque from the teeth. Failure to do this can lead to plaque hardening to tartar, resulting in infection and irritation of the gums (gingivitis and periodontitis). An untreated cavity can lead to a deep infection in the tooth called a tooth abscess, which can destroy the pulp inside the tooth, potentially requiring tooth removal or extraction. 1
You can reduce your risk of dental caries and gum disease by practicing good oral hygiene. Regular professional cleaning every 6 months can help in preventing cavity formation. It can also help with the early detection of problems in high-risk areas of the mouth. Express Dentist can connect you to top-rated dental clinics in your area for all your dental care needs – whether it is preventive care and regular professional cleaning or 24-hour services for dental emergencies.
Types of tooth extraction
Dentists can perform different types of tooth extractions depending on the shape and size of the tooth as well as its position or location in the mouth. Broadly speaking, tooth extractions are simple or surgical. 2
A simple tooth extraction consists of the removal of an erupted or exposed tooth with forceps. Because the tooth is visible above the gum line, the dentist can remove the entire structure of the tooth in one piece. This may be followed by some minor smoothening of the bone socket.
Surgical tooth extraction is more complex. It involves the removal of the tooth root as well as soft tissue and bone. It may involve making an incision (cut) in the gum tissue and removing some bone. The oral surgeon may need to remove the tooth in more than one piece.
Wisdom tooth extraction
Wisdom tooth is the common name by which most people know the third molar. There are four wisdom teeth in the mouth. They are permanent teeth located in the back corners of the mouth, one each on the right and left, top and bottom.
The wisdom teeth are the last to erupt, usually between the ages of 17 and 25. In some people, wisdom teeth never erupt at all. In others, they erupt normally and do not cause any problems. However, in some individuals the wisdom teeth become impacted, i.e., they do not fully emerge from the gums. Impaction can cause the wisdom tooth to grow at an angle towards the adjoining tooth or the back of the mouth. 3
Impacted wisdom teeth may require extraction, especially if they are causing problems such as pain, infection, tooth decay, damage to the adjoining tooth or bone, or complications during orthodontic treatment. Wisdom tooth extraction is a common procedure that can usually be performed without any long-term complications.
Preparing for tooth extraction
Before you undergo a tooth extraction, you will have a consultation with a dentist or oral surgeon in the office. At this time, your doctor will obtain a complete health history and a list of medications and allergies. Some medications need to be stopped in preparation for a dental procedure. Also, your dentist may give you certain medications to take before or on the day of the tooth extraction procedure.
Blood thinners are medications that, as the name suggests, make the blood thinner and prevent the formation of blood clots. These medications increase the risk of bleeding during any type of surgical procedure, including dental procedures. If you take a blood thinner, it is important to let your dentist know. Your dentist may recommend that you switch to another medication or temporarily stop taking the blood thinner in preparation for your tooth extraction. They may order a blood test before scheduling the extraction. It is not always necessary to stop taking the blood thinner before the tooth extraction. The dentist can control minor bleeding at the site of the tooth removal with gauze, topical clotting medication, or stitches.
Antibiotics may be prescribed as a preventative measure before tooth extraction in some people. For instance, in someone with a dental infection and systemic (body-wide) symptoms like fever and malaise, as well as local swelling in the mouth, an antibiotic may be prescribed to treat the infection. Also, people who have structural abnormalities of the heart valves or prosthetic (artificial) heart valves or certain congenital heart abnormalities are at high risk of endocarditis (infection of the inner lining of the heart) after dental procedures. The American Dental Association and the American Heart Association recommend antibiotic prophylaxis before dental procedures in such high-risk individuals. 4
Anesthesia for tooth extraction
Tooth extraction can be performed under local anesthesia with or without sedation or under general anesthesia. Local anesthesia involves the injection of numbing medicine in the gums close to the site of the extraction. This makes the area numb so that you don’t feel anything when the dentist removes the tooth. The numbness wears off a few hours after the procedure.
Your dentist may offer sedation to reduce anxiety and nervousness and help you relax during the tooth extraction. This can be in the form of an oral medication, intravenous (IV) sedation through an IV line in a vein, or nitrous oxide (commonly called laughing gas). This is called conscious sedation, meaning you are awake but drowsy during the procedure. You will need a ride home from the dental office if you have tooth extraction with sedation. The effects of nitrous oxide wear off quickly, however, and you may be able to drive yourself home if it is used along without other sedating medication.
If the tooth extraction is a complex one, it may be done under general anesthesia, in which case you will be asleep during the procedure. If general anesthesia is required, you may need to go to an oral surgeon because many dentists do not have this option at their office.
Tooth extraction procedure
The dentist will start the procedure by taking an x-ray of the tooth being extracted. This helps them see the angle and curvature of the tooth root and guides the extraction. Following the x-ray, you will receive the anesthetic. After allowing some time for the numbing medicine to work, the dentist will start the extraction.
For a simple extraction, the dentist may be able to pull the tooth out in one piece with forceps. For more complex extractions, they may remove the tooth in several pieces. An incision may need to be made in the gums if some part of the tooth is impacted below the gums or in the bone. They may need to cut away some of the gum tissue and bone to free up the tooth.
Once the offending tooth is out, some treatment may be needed to control bleeding, including the application of a topical clotting medication or placement of stitches. Your dentist will place a thick piece of sterile gauze on the extraction site and have you bite on it to stop bleeding. The pressure from the gauze helps the body’s natural clotting process.
Is tooth extraction painful?
Tooth extractions are not painful because numbing medicine works well. However, you may feel a sensation of pulling or pressure as the dentist works with various instruments to loosen the tooth. You may also hear some grinding noises, which can be distressing. If you feel like these sensations and noises may be unpleasant for you, speak to your dentist beforehand about sedation to minimize anxiety. If you experience pain during the tooth extraction, tell your dentist immediately. They will use more numbing medicine to keep you comfortable.
Recovery and aftercare for tooth extraction
As noted, your dentist will place a thick piece of sterile gauze at the extraction site to control bleeding. They will keep you in the office for at least 30 minutes to ensure there are no complications and the bleeding is under control before allowing you to go home. While you wait in the observation area, keep firm pressure on the extraction site by biting down on the gauze. It is not unusual for some bleeding to continue for 1-2 days after the tooth extraction.
Brushing and flossing
Your dentist will give you instructions about when you can safely rinse your mouth and brush and floss your teeth. You may be advised to avoid brushing or flossing for the first 12 hours after the tooth extraction. You can rinse your mouth with warm salt water starting the day after surgery to reduce gum soreness and inflammation. Speak to your dentist about restarting the use of alcohol-containing mouthwash if you used it before the tooth extraction.
Eating and drinking
Your dentist will also tell you about the types of foods to eat and which ones to avoid for a few days while the extraction site heals. In general, eating solid, hard, crunchy, or chewy foods should be avoided, as should drinking alcoholic beverages. You should continue to drink plenty of fluids and eat soft, nutritious foods. You can slowly reintroduce all types of food back into your diet, taking care to chew on the opposite side from the extraction for the first few days until the wound heals.
Extraction site care
It is important to avoid irritating the extraction site for the first 24-48 hours. You should avoid touching it with your tongue, rinsing your mouth too vigorously, or drinking with a straw.
Potential complications of tooth extraction
In the hands of an experienced dentist, tooth extraction is a pretty standard procedure. However, like any surgical procedure, tooth extraction can sometimes lead to complications.
Bacteria can sometimes infect the tooth extraction wound (gums and tooth socket) 1-2 days after the procedure. This can cause symptoms like pain, swelling, pus, fever, and swollen glands in the neck. If you experience any of these symptoms after tooth extraction, you should get in touch with your dentist as soon as possible. It is important to go to the follow-up appointment, which is usually scheduled one week after the tooth extraction, so the dentist can make sure everything is healing up nicely.
One of the complications of tooth extraction is alveolar osteitis or dry socket. This happens when a blood clot does not form over the extraction site or forms but becomes dislodged, exposing the bones and nerves. People who smoke or chew tobacco or have poor oral hygiene are at greater risk of developing this complication after tooth extraction. Women who are on birth control pills or hormone replacement therapy may also have a higher risk of dry socket. Drinking with a straw while the tooth extraction site is healing increases the risk of the blood clot dislodging, leading to a dry socket.
Symptoms of a dry socket include severe pain immediately after or a few days following the procedure and a foul smell in the mouth. There may be visible bone at the extraction site. If you experience any of these symptoms, you should get in touch with your dentist immediately.
Dry sockets can be treated by flushing the area to clear any debris that is irritating the wound. The dentist may pack the wound with a medicated dressing to encourage healing. You will also be prescribed NSAIDs (pain medications like ibuprofen) and a medicated rinse to use for several days at home. You should keep all your follow-up appointments with your dentist to ensure the tooth extraction site heals completely.
Tooth extraction cost
The cost of tooth extraction can vary greatly depending on your geographical location, the type of extraction (simple vs surgical), and the expertise of the provider (oral surgeons are usually more expensive than general dentists). Wisdom teeth removal costs are also affected by how complex the procedure is and what kind of anesthesia is used. The average costs of tooth extractions are as follows:
- Routine extraction $150 to $250
- Surgical extraction with gum tissue and/or bone removal $250 to $350
- Complex wisdom tooth extraction $300 to $500
While the cost of the local anesthetic is generally included in the cost of the tooth extraction, there may be additional charges for sedation. Also, dental x-rays may be extra, typically ranging from $30 to $75. A panoramic x-ray that provides an image of the whole mouth including the wisdom teeth costs around $125. Your dentist will give you a quote for your tooth extraction after examining your teeth and determining the complexity of the procedure.
In terms of coverage under dental insurance plans, routine dental extractions and wisdom tooth extraction cost are covered by some plans. However, you will need to check your policy document to see what portion of the cost will be covered. The insurance policy usually dictates what types of oral surgeries are covered, depending on how complicated it is, which tooth is involved, and requirements for anesthesia and sedation, etc. Some policies only cover dental procedures that are deemed medically necessary, i.e., necessary for your overall health and wellbeing.
How to find a dentist for tooth extraction near me?
Express Dentist is a nationwide network. You can call (844) 593-0591 to get help from a local dentist in your area.
Each of our partner dentists is vetted to ensure you get the highest quality of dental care. When you call Express Dentist, you can be sure you will receive superior care from accredited practitioners at affordable prices. Call Express Dentist today for trusted dental referrals all over the US. Our 24-hour hotline gives you instant access to dentists with extensive experience in tooth extraction and other dental procedures.
About the author
Dr. Greg Grillo
Dr. Greg Grillo DDS studied at the University of Washington where he received a bachelors degree with Honors and later attended dental school on the same campus. Following school Dr. Greg served in the United States Navy as a dental officer. During this time he received advanced training in specialty areas of dentistry while also treating families of members of the military.
As well as sharing valuable information on dentistry and oral health, Dr. Greg remains a practicing dentist to this day. He works with families in the Okanogan Valley where he lives with his wife and three children.
- Medline Plus. Dental Cavities. Available online. Accessed on March 14, 2021.
- American Dental Association. ADA Guide to Extractions – Tooth and Remnants. Available online. Accessed on March 14, 2021.
- Mayo Clinic. Wisdom Tooth Extraction. Available online. Accessed on March 14, 2021.
- American Dental Association. Antibiotic Prophylaxis Prior to Dental Procedures. Available online. Accessed on March 14, 2021.